Revolutionary rotator cuff treatment regenerates and protects the shoulder from re-injury

Advances in surgery have made possible a better repair of the rotator cuff. But the failure rate for surgery can be high. (CREDIT: Adobe images)

Tears to the major tendons in the shoulder joint, commonly referred to as the rotator cuff, are common injuries in adults. Advances in surgery have made possible a better repair of the rotator cuff. But the failure rate for surgery can be high.

Massive rotator cuff tears (MRCT) of the upper arm cause disability and pain in the adult population. In chronic injuries, tendon retraction and subsequent loss of mechanical load over time leads to muscle atrophy, fat accumulation, and fibrosis.

The intrinsic mechanism of muscle repair and successful repair of a torn tendon cannot reverse muscle degeneration after MRCT.

Now, a team of researchers at the University of California, Connecticut School of Medicine, led by surgeon, engineer and scientist Dr. Kato T. Laurencin, reports that a graphene/polymer matrix embedded in the shoulder muscle can prevent re-injury.

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“Most surgeries focus on the tendon and how to most effectively attach it to the bone,” Lorensen says. But the real problem is that the muscle degenerates and accumulates fat.

When a muscle is torn, it contracts and the body fills with fat in that area instead. When the tendon and muscle are finally surgically reattached to the humerus, the weakened muscle cannot withstand normal stress and the area can be damaged again.

Dr. Lorensen, along with graduate student Niku Shemshaki, worked with other researchers at the University of California, Connecticut’s Convergence Institute to develop a polymer mesh filled with graphene nanosheets.

A rotator cuff tear occurs when the tendons, the fibrous connective tissues that connect muscles to bones in the shoulder area, are pulled further away from the humerus, that is, the humerus, which in turn causes muscle tension, pain, and discomfort. This is because the shoulder is essentially a ball and socket joint, which requires muscles, bones, and tendons to remain in an area of ​​motion. There are two types of ruptures of the rotator cuff – partial and complete. In a partial rupture, the tendon is torn off only to some extent, and a piece of tissue is still attached to the humerus. A complete rupture occurs when the tendon is completely detached from the humerus. (CREDIT: Creative Commons)

When they used it to repair the shoulders of rats that had chronic rotator cuff tears with muscle atrophy, the muscles grew back. When they tried to grow muscle on a grid in a petri dish in the lab, they found that the material seemed to promote the growth of myotubes, muscle precursors, and inhibit fat formation.

“This is really a potential breakthrough in the treatment of rotator cuff tears. It solves a real problem: muscle degeneration and fat accumulation,” Lorensen says.

Dr. Kato T. Laurensen of the University of California, Connecticut School of Medicine.

The next step in their work is to study the matrix in a large animal. The team is looking forward to developing the technology in humans.

Symptoms of a rotator cuff injury

Pain associated with a rotator cuff injury can:

• Described as a dull ache deep in the shoulder

• disturb sleep

• Interfere with combing your hair or reaching behind your back

• Accompanied by hand weakness

• Some rotator cuff injuries do not cause pain.

Causes

Rotator cuff injuries are most commonly caused by progressive wear and tear of tendon tissue over time. Repetitive overhead exercises or prolonged heavy lifting can irritate or damage the tendon. The rotator cuff can also be damaged in a single incident during falls or accidents.

Risk factors

The following factors may increase the risk of rotator cuff injury:

• Age. The risk of rotator cuff injury increases with age. Rotator cuff tears are most common in people over 60 years of age.

• Some lessons. Jobs that require repetitive overhead arm movements, such as carpentry or painting work, can damage the rotator cuff over time.

• certain sports. Some types of rotator cuff injuries are more common in people who play sports such as baseball, tennis, and weightlifting.

• Family history. There may be a genetic component associated with rotator cuff injuries as they are more common in certain families.

Complications

Left untreated, problems with the rotator cuff can lead to permanent loss of mobility or weakness of the shoulder joint.

This work was funded by NIH National Institute of Arthritis, Musculoskeletal and Skin Diseases Grant No. DP1AR068147 and Emerging Frontiers in Research and Innovation Grant No. 1332329 from the National Science Foundation.

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Note: Materials provided above by the University of Connecticut. Content can be edited for style and length.

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